Inattentive ADD will soon be called Sluggish Cognitive Tempo (SCT). Russell Barkley among other experts have stopped including the Inattentive subtype of ADHD in discussions about ADHD. It seems that the consensus is that Inattentive ADD is more like SCT than it is like ADHD.
Where it matters, that is, response to treatment, the modalities that work for treatment, the life outcomes, we are more like SCT than we are like ADHD. The experts have been saying forever that the Inattentive type is significantly different from the other types of ADHD and that this subtype is if fact another entity. There has been very little research done on SCT but for lack of another home, we are headed there.
In this 2008 video Russell Barkley speaks for over 15 minutes about Sluggish Cognitive Tempo. In this video he basically reports that Inattentive ADHD is not ADHD at all and that people who are primarily inattentive have a condition that is called Sluggish Cognitive Tempo (SCT).
The SCT that Barkley describes is a disorder characterized by a sluggish sensory processing.
This video is a great outline of what we know about SCT. More research is needed and I believe that research will show that all of us are on a continuum of sensory processing that may be delayed in some areas and normal in others. Recently I read an article that implicated sluggish sensory processing in people diagnoses with dyslexia. We do know that not everyone with SCT or Inattentive ADHD is dyslexic but we also know that there is a fair amount of overlap between these conditions.
A new diagnosis in the DSM V (the diagnostic manual that psychiatrist use to diagnose and treat) will mean more money devoted to figuring out what works for folks like us. That can only be a good thing.
I'm happy that there are new breakthroughs and ways of thinking about Primarily Inattentive ADD, but something about this bugs me! Maybe it's just that I resent the implication that I am "slow." Yes, it takes me forever to do most things, but if I hear someone ask themselves outloud the definition of a word, I'll have looked it up and read it to the person before anyone else even thought to do so. How does SCT explain hyperfocus or selective focus on things we find interesting or pleasureable? Yes, I guess it's a good thing, but I hope it doesn't lead doctors in the wrong direction. Guess I have to go and actually watch the video before I make any permanent harsh conclusions about this new "consensus." ;) As always, thanks for keeping me abreast of the latest in the field of inattentive ADD!
ReplyDeleteIt goes both ways. While it certainly does have a negative connotation, I am extremely pleased with the disassociation from ADD/ADHD, which have been lampooned within our society to the point of not being taken seriously by many. I'll probably be tempted to continue using 'ADD' in job-application disclosures in the future, since many employers will take it less seriously than someone 'sluggish', vis a vis productivity.
ReplyDeleteThe name that they have decided to use for this condition is most unfortunate!! It sounds less like a clinical diagnosis and more like a school yard insult.
ReplyDeleteSince most of the problem in this condition seems to be with the speed of sensory processing, maybe a better term would be something like 'Sensory Processing Speed Disorder'.
As anonymous has pointed out, most of us have felt as though we have little in common with the ADHD camp. A new diagnosis will mean that more patients and parents will recognize themselves and their children in the diagnosis that they are given and this can only mean that more people with this problem will be helped.
Inattentive ADD was a poor fit in the ADHD camp. I think we will fit in better with the "Sensory Processing Speed Disorder" group.
I don't think that everyone with ADD symptoms has SCT. My husband, daughter, and brother-in-law seem to have this, and that makes a lot of sense! In fact, it has already been suggested that my daughter might have a working memory/processing speed issue. (I have little in the way of executive functioning--and that seems to be a familial trait--but don't seem to have sluggish processing...what is that called? I hope it's not just considered laziness again!!)
ReplyDeleteAlso, aren't certain behaviors like hair twirling, thumb sucking, and fidgeting part of the "H"? We've got those. My daughter can't sit without doing the splits, or stretching, or sucking her thumb, etc.
I'm fairly new to this, so forgive me! I expect we'll know more after her neuropsych.
-Nicole
Nicole,You are right. Not everyone with ADD has SCT. The percentage of people with ADD that have SCT is about 30 to 50% but because the experts have decided that ADD is not sufficiently similar to ADHD to leave it in that diagnosis, they are considering moving it into the SCT camp.
ReplyDeleteThe fidgeting can be one of the hyperactive signs but to be considered hyperactive you have to have the entire profile of hyperactivity. Yes, the working memory problems are seen in both ADD and SCT and may be the great uniting symptoms of these two disorders. Thanks for your comment. Tess
If I ruled the world I would call it Inconsistent Cognitive Tempo. I think it defines a larger portion of what's going on in the life of someone with SCT- we can't always choose when we can bring our A game. Besides not exactly loving to be called dumb, I think it would help newcomers who are reluctant to acknowledge their condition.
ReplyDeleteOkay fine, I'm a slug, but come-ON, leave me with some dignity. It's already hard enough being a slug, I've got to be called one now. Whatever, suppose it could be worse.
I think I will make you ruler!! Thanks for your comment.
ReplyDeleteThe segment on SCT in this video starts at 21:50. Thanks for postiing Tess
ReplyDeleteThanks John!!
ReplyDelete